State audit: Veterinary board must improve drug security
The Oregon Veterinary Medical Examining Board hasn't properly inspected facilities across the state for compliance with Drug Enforcement Agency regulation and or done required background checks on licensees, a state audit found.
Those lapses increased the risk that prescription drugs meant for animals have been illegally diverted to human use, contributing to the opioid crisis, auditors concluded in a report released Thursday, Nov. 14.
Auditors recommended that the veterinary profession be required to participate in the state's prescription monitoring program, losing an exemption that has spared veterinarians the need to report.
At the crux of the audit, the Veterinary Board's negligence has put public health and the protection of animals at risk. "Oregon is in the midst of an opioid epidemic and the Governor has indicated that addressing the issue is a high state priority," the audit said. "While much of the focus has been on medical doctors and pharmacists, (vets) prescribe and dispense many of the same controlled substances used by human practitioners, including opioids."
According to the audit, veterinary facilities often operate as both doctor and pharmacy, allowing many workers access to powerful prescription drugs that divert.
The board monitors more than 650 facilities and approximately 4,000 vets and vet technicians around Oregon. That responsibility includes licensing both people and facilities as well as investigating public complaints.
The board's eight members are appointed by the governor and include five vets, one vet technician and two public members. It also employs an executive director, inspector, investigator and an office specialist.
While Oregon's role in the nationwide opioid crisis has focused on medical doctors and pharmacists, the veterinary industry can also contribute to prescribed substances ending up in the wrong hands, the audit said.
The National Center for Health Statistics reported 341 opioid-related deaths in Oregon from
According to the audit, controlled substances prescribed in veterinary medicine are identical to those used in human medicine.
Tramadol, fentanyl, hydrocodone, Xanax, and Valium can be used to treat dogs, cats and other animals. Smaller dosages for animals can be combined to provide enough strength to get a human high, according to auditors.
A survey of veterinary professionals conducted by auditors this year showed that more than 23% of respondents said they've seen an increase in the number of odd or suspicious interactions with patient's owners over the last three years, and 15% said they suspected a co-worker of stealing drugs during that same period.
The audit commends the board for its adherence to the Oregon's Veterinary Practices Act, criticizes them for inadequate inspection processes. Before 2015, the board only conducted inspections upon complaint, but finding facilities were falling short of minimum cleanliness and safety standards, decided to ask the legislature to amend the Veterinary Practices Act allow them to make regular facility inspections. The board adopted an inspection survey from the state of Virginia as its own checklist but failed to include Virginia's detailed steps related to controlled substance and patient record review. Many states — such as California and Arizona — have statewide inspection processes that include checking drug security and inventory logs, according to the audit.
The audit also finds that, unlike Oregon's six other health licensing boards, the Veterinary Medical Examining Board doesn't independently check the backgrounds of applications, relying on self-reporting of criminal charges to be considered in the licensing.
"Background checks in and of themselves may prevent those with arrests or convictions from even applying for a license," the audit said, "and would eliminate the risk of someone with a diversion-related felony arrest or conviction being licensed and having access to controlled substances."
The board in 2014 considered rules to require criminal background checks but never implemented the change because of negative feedback from the public. The board in July proposed again requiring background checks, and new rules were adopted last month.
In a letter to the audits division dated Nov. 12, Executive Director Lori Makinen agreed with the recommendations provided by auditors and acknowledged the board would move forward in working with the Legislature and Oregon Health Authority to require veterinarians be included in the state's Prescription Drug Monitoring Program reporting requirements.